A bi-partisan plan to ensure seniors who rely on Medicare aren’t denied access to doctors passed the U.S. House of Representatives on Thursday.
The plan works by permanently fixing the rates at which doctors are reimbursed for Medicare patient visits. Without the fix, on April 1, physicians would face a 21 percent cut in their reimbursement from Medicare, which would force many to stop seeing Medicare patients altogether.
U.S. Representative Martha Roby, who voted in favor of the plan, said this proposal is a long-term solution that makes sense.
“Seventeen times now, Congress has put a temporary ‘Band-Aid’ fix on the Medicare reimbursement issue,” Rep. Roby said. “It’s time for a solution that is both lasting and healthy for our country over the long term. This plan makes sure seniors who rely on Medicare aren’t denied access to doctors.”
In 1997, Congress enacted a system to determine Medicare reimbursements called the Sustainable Growth Rate, or SGR. This system was tied to the nation’s Gross Domestic Product, meaning the formula was susceptible to economic downturns and rising health care costs, both of which have been an issue since. Already faced with increased costs, many doctors would not have be able to afford seeing Medicare patients given a steep drop in their reimbursement fee.
In 2003, Congress began passing short-term measures that temporarily prevented the problem from manifesting. Seventeen short-term “doc fix” proposals have passed since, while a permanent solution remained elusive.
H.R. 2, the Medicare Access and CHIP Reauthorization Act, repeals the Sustainable Growth Rate and replaces it with a new system that seeks to reward doctors for quality care instead of patient volume. As indicated in the title, the bill also extends funding for the Children’s Health Insurance Program (CHIP) as well as community health centers for two years.
The cost is $210 billion over ten years, $70 billion of which is offset through a combination of increased payments from Medicare beneficiaries, including means testing of high-income beneficiaries.
According to the Congressional Budget Office, this long-term fix saves taxpayers almost $1 billion over 10 years compared to perpetual temporary fixes.
“I’m not for raising taxes, as some have insisted must happen for this to get done,” Rep. Roby said. “I’m for structural changes that ensure our seniors can count on healthcare and make fiscal sense long term. Now we have a solution that meets the criteria.
“Every year since I’ve been in Congress, we have had to ‘kick the can down the road’ on Medicare SGR reform. I’m pleased we can finally deliver a good product, one that is a great first step toward more meaningful entitlement reforms.”
For more information about H.R. 2, the Medicare Access and CHIP Reauthorization Act, visit http://energycommerce.house.gov/sites/republicans.energycommerce.house.gov/files/114/Analysis/20150324-HR2-SectionbySection.pdf.
For analysis on the importance of a permanent SGR solution from Quin Hillyer, visit http://www.nationalreview.com/corner/415865/yes-very-good-reformist-permanent-doc-fix-quin-hillyer.
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